Cannabis use Disorder, Dependence and Addiction

Let’s talk about CUD – cannabis use disorder.

There are a great many positives to cannabis use. It is relaxing, can be fun, and has a wide range of potential medical uses. However, these benefits can be outweighed by the negatives – cannabis use can quickly become damaging, and long term use has been linked to a higher risk of multiple, serious health concerns.

These concerns include an increased risk from heart and lung disease and stroke, damage to working memory, and the development of various mental health disorders like psychosis, paranoia, depression, and anxiety.

There is a line, often blurry, between healthy use and unhealthy use. Where we cross this line into unhealthy use, CUD comes knocking.

What makes it cannabis use disorder?

So, what is this line? What separates casual, healthy use from cannabis use disorder?

CUD is a diagnosis that covers everything from mild to severe marijuana use. However, it is still its own entity. To be diagnosed with cannabis use disorder, you will need to present at least two of eleven clearly defined symptoms laid out by the DSM-5 within the same 12-month period.

The symptoms of cannabis use disorder

These eleven symptoms are:

A loss of control, using increasing amounts of cannabis, and/or using it for longer time periods than intended or desired

Social impairments, finding it hard to engage in work, with your social circle, or to take part in hobbies and recreational activities because of cannabis use

Inability to stop, being unable to quit when you want to, which shows the seeds of addiction quite clearly

Ignoring risks, turning a blind eye to the dangers surrounded ongoing cannabis use

Cravings, feeling a need to experience cannabis when not using it

Frustration of existing issues, using cannabis even though it is exacerbating an existing psychological or physical concern

Troubles in main spheres of life, being unable to perform your normal behaviour patterns or fulfil your normal duties at work or home

Tolerance building, needing increasing amounts of cannabis to elicit the same effects

Disregarding problems caused by use, ignoring the negative impacts of cannabis

Withdrawal, experiencing the symptoms of withdrawal when not using cannabis, or when stopping completely

Disproportionate focus, spending too much time and effort on cannabis use to the detriment of other things.

As you can probably see, there are physical, biological, and psychological, social elements to cannabis use disorder. One alone is generally not considered too much of a concern. However, if you experience any, you should consider cutting down your cannabis use, or cutting it out entirely.

Cannabis can be an addictive drug. As we have seen, it can cause cravings and withdrawal, in keeping with many other addictive substances. If you recognise one or more of the above symptoms, you should consult your healthcare provider for further information and help.

How does cannabis use disorder occur?

Cannabis use disorder is a complex thing. Its causes are therefore complicated and often varied. Lifestyle factors, genetics, mental health, and physiology all combine to determine whether or not somebody will develop it.

However, there is a chemical component to cannabis that can be addictive. It can cause you to rely on it.

Cannabis contains tetrahydrocannabinol (THC). THC is its primary psychoactive ingredient – it is what causes the high for which cannabis users search. It works by triggering the endocannabinoid receptors in your brain. When you use addictive drugs like cannabis, especially but not only long term, your brain’s circuits change.

This is a crude way of putting it, but it serves our purposes.

This is where and how desensitisation occurs. Over time, you will become less sensitive to THC even as you become more reliant on it.

This is because your brain’s circuits have evolved to need a baseline amount. Before meeting this baseline amount, that high you are chasing won’t occur. And, over time, this baseline amount rises. You will need more and more THC to get the same effect from it.

You will also need more and more THC to simply feel ‘normal’. Going under this baseline amount will feel horrible. Withdrawal symptoms will likely occur. Therefore, to simply function without these withdrawal symptoms coming into play will require your baseline cannabis intake – you will not be able to get by without it.

You will be addicted. Cannabis use disorder will by then be in full swing.

The signs of cannabis abuse

Many people can have a healthy relationship with cannabis. However, around a third of all cannabis users will have an unhealthy one. Their relationship with cannabis will be problematic and damaging.

Spotting the signs

There are certain signs of cannabis abuse disorder that you can look out for. These are good to know, either for yourself or for those around you. If you or anyone around you is showing any of the following signs, you or they may be suffering from Cannabis abuse:

• Reddened eyes
• Excessive, uncontrolled eating, or eating outside of normal meal times
• Poor performance at work, in meeting responsibilities at home, or in school
• Withdrawal from social situations
• Prioritising socialising with other users
• Spending a large amount on cannabis and cannabis related products, such as bongs
• Extensively researching cannabis products

There are also plenty of long-term side effects that come with cannabis use disorder. These can include withdrawal from social situations, but also withdrawal into yourself, being unable to focus on or connect with other people. Cannabis can make it hard to pay attention, to think or take in information.

If you suffer from any pre-existing mental health problems, cannabis use can exacerbate them, making symptoms worse. Those who use cannabis, who are more likely to suffer from mental health concerns, are more likely to be unemployed and unsatisfied with life.

Who might suffer from cannabis use disorder?

Realistically, anybody who uses cannabis can develop and suffer from cannabis use disorder. As above, around a third of users will develop it.

However, you will be more likely to develop CUD if you suffer from any pre-existing mental health problems such as mood disorders, anxiety, or psychosis. You will also be more likely to develop it if you misuse other drugs, like alcohol or cocaine. Environment can also play a part, with those growing up or living around heavy drug use being more susceptible.

Genetic heritage can also play a part – some of us are simply genetically more predisposed towards addiction.

How to treat CUD

There are several ways you can go about treating cannabis use disorder.

The first and most obvious way is to avoid developing CUD in the first place. You can do this by not using cannabis to begin with. Abstinence during adolescence is particularly helpful, here. During adolescence, your brain is still developing, so those circuits we mentioned earlier are more vulnerable to change.

If you are going to use cannabis, avoid doing so with other drugs. As we have seen, using it in conjunction with other addictive substances like alcohol can significantly increase your risk for developing an addictive disorder.

However, if you do find yourself suffering with CUD, you should seek out treatment. If you know anyone suffering from it, or whom you suspect of suffering from it, encourage them to seek help. This is important, as many people with CUD don’t.

Help with CUD

Psychotherapy or talking therapy can be very useful. It can get to the heart of the drug abuse and support you as you come out of it. This can include things like CBT (cognitive behavioural therapy), MET, (motivational enhancement therapy) and CM, (contingency management). All of these can help you as you change your behaviours and the thoughts underpinning them, which can otherwise make addiction recovery impossible.

These treatments can help all ages. However, for young people, psychotherapy can often be far more effective when loved ones are involved. MDFT (multidimensional family therapy) can be great, especially for adolescents.

Medication is a bit of an unknown factor in treating cannabis use disorder. We have already seen that it’s common to go through withdrawal symptoms as you quit. As with any addiction, relapse is also a constant fear. Antidepressants, mood stabilizers, insomnia medicine, and cannabinoid agonists might be of some use, though there is no set, approved course of medication to help with CUD.

Support groups have shown to be hugely effective in helping those who suffer with a drug and alcohol use disorder to achieve and maintain abstinence. If your having trouble quitting the marijuana on your own, a support group such as Marijuana Anonymous can make all the difference.

You can also use Recoverlution to connect with wellness and like-minded others. CUD can be treated effectively and recovery can be maintained. Its all about finding what works for you.

Read more:

Spotting the signs of Cannabis addiction

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2797098/